RSS Feedhttps://10.40.239.128/blogs/rss-feed/Blog RSS Feeden{4B4BA792-2BAB-4FD4-B936-9FC0AC549229}https://10.40.239.128/blogs/2015/07/cervical-cancer/Cervical Cancer - Proper Screening Saves LivesOriginally pioneered in the early 1900s by Greek physician Dr. Georgios Papanikolaou, the Pap smear picks up mild, early changes that can be treated years before the human papiloma virus, or HPV, actually causes cervical cancer.&nbsp;
<p><strong>What exactly is a Pap smear?</strong>&nbsp;</p>
<p>Many patients confuse a Pap smear with a a pelvic exam, which is when a speculum is placed in the vagina and a healthcare provider checks the size and shape of the uterus and ovaries. A Pap smear or cervical cytology is a test that requires a healthcare provider to sample cells on the cervix using a flexible brush after a speculum is placed. So, a woman may have a pelvic exam in the emergency department or physician office without having cervical cancer screening. It is important to review your records or ask your healthcare provider if you are up to date on your Pap smear.&nbsp;</p>
<p><strong>What is the Human Papilloma Virus (HPV)?</strong>&nbsp;</p>
<p>HPV is very common. Nearly all sexually active people are exposed to it at some point in their lives. It is spread by having vaginal, anal or oral sex with someone who has the virus. It can be spread even when the infected partner doesn&rsquo;t have any signs or symptoms. While condoms can decrease the chance of infection, there are areas that are not covered by a condom so complete protection is not guaranteed. Even if a woman has just one sexual partner, her risk of HPV infection is about 10 to 20 percent. Symptoms can develop years after the exposure, so it is often difficult to know when infection occurs.&nbsp;</p>
<p>Certain high-risk types of HPV (16, 18, 45, 31, 33, 52, 58 and 35) account for 95 percent of cervical cancers. Most HPV infections are temporary and the immune system can clear the virus. However, a small percentage of women will have a persistent infection lasting two years or longer and these are more likely to lead to severe changes on the cervix or cancer. Having a suppressed immune system, the HIV virus or smoking cigarettes all increase the risk of having a persistent infection more likely to lead to cervical dysplasia.&nbsp;</p>
<p><strong>When do I need cervical cancer screening?</strong>&nbsp;</p>
<p>In the past, cervical cancer screening recommendation was to have a Pap smear yearly. <strong>For most patients, the new recommendations are:</strong>&nbsp;</p>
<p>- Start screening at 21 years of age (regardless of age of first intercourse). Cervical cancer before this age is very rare.&nbsp;</p>
<p>- 21-29 years of age, cervical cytology (Pap smear) without HPV testing every three years&nbsp;</p>
<p>- 30-65 years of age cervical cytology (Pap smear) PLUS high-risk HPV testing every five years is preferred; another option is to have a Pap more frequently (every three years) without high-risk HPV testing.&nbsp;</p>
<p><strong>Why the Change?</strong>&nbsp;</p>
<p>Large-scale studies sow that normal Pap smear results in patients younger than 30 or in older patients who don&rsquo;t have high-risk HPV have such a low chance of developing cervical cancer that they can go 3-5 years until their next cervical cancer screening. Studies show that yearly Pap smears double or triple the interventions such as biopsies or procedures to remove part of the cervix without preventing cancer of the cervix.&nbsp;</p>
<p>Even with mildly abnormal results, 90% of adolescents and 75% of adult Pap smears will normalize. Screening women less than 30 years of age for high-risk HPV is therefore not helpful because it so often resolves and testing might lead to increased unnecessary interventions.&nbsp;</p>
<p>Don&rsquo;t forget, screening tests are for patients who are not having any symptoms. If you are having irregular periods, bleeding after intercourse, bleeding after menopause or other concerns, these symptoms need to be evaluated even if the most recent Pap test was normal. Make an appointment if you are having problems.&nbsp;</p>
<p><strong>What if my test is abnormal?</strong>&nbsp;</p>
<p>For some women, an examination with a colposcope (an instrument that allows a closer look at the cervix) and a biopsy maybe recommended after an abnormal Pap. Cervical intraepithelial neoplasia (CIN) describes the extent of the abnormality of the cells. CIN 1 is mild, CIN 2 indicates moderate changes and CIN 3 means severe changes that are more likely to lead to cervical cancer.&nbsp;</p>
<p><strong>Special Circumstances</strong>&nbsp;</p>
<p>For women who have had a hysterectomy with removal of their cervix and no history of CIN 2 or higher, there is no need for future screening and HPV testing. Such women with a history of CIN 2 or higher should continue to be screened. Women who have had their uterus removed but not the cervix should continue routine cervical cancer screening.&nbsp;</p>
<p>In addition, women who have risk factors for cervical cancer need more frequent cervical cytology screening. Such factors include:&nbsp;</p>
<p>- A suppressed immune system (following organ transplant or on medication for systemic lupus erythematous)&nbsp;</p>
<p>- Being exposed to diethylstilbestrol (DES) in utero&nbsp;</p>
<p>- An HIV infection&nbsp;</p>
<p>- Previously having CIN 2 or CIN 3 or cervical cancer&nbsp;</p>
<p><strong>When can I stop having Pap smears?</strong>&nbsp;</p>
<p>After age 65, screening can be discontinued if a woman&lsquo;s last three Pap smears were normal (or last two Pap smears show negative high-risk HPV testing in the last 10 years) and she doesn&rsquo;t have a history of severe changes in her cervix (CIN 2 or 3). Women with a history of CIN 2 or CIN 3 need screening for 20 years regardless of age.&nbsp;</p>
<p><strong>Fighting HPV</strong>&nbsp;</p>
<p>In addition to regular screening, women can proactively fight HPV and cervical cancer. The recommendation is clear that boys and girls should receive the HPV vaccine at 11-12 years of age. If men and women under the age of 27 have not yet received the vaccine, they should. The vaccine provides protection against HPV types 16 and 18, which cause 70 percent of cervical cancers. For now, Pap smear screening recommendations are the same for women who have received the vaccine.&nbsp;</p>
<p>Anything that disrupts your immune system from fighting off viruses could allow HPV to cause more problems. For instance, smoking quadruples a woman&rsquo;s risk for cervical cancer. By maximizing your nutrition, rest and general health, you can do your part in fighting HPV.&nbsp;</p>
<p><strong>Don&rsquo;t neglect your gynecologist!</strong>&nbsp;</p>
<p>Even though you likely won&rsquo;t need to have Pap smears as often as in the past, yearly exams are still recommended for many reasons. Schedule your appointment today!</p>Tue, 14 Jul 2015 00:00:00 -0600{FB591E23-6663-4F2D-810F-3AC5B4B0DAA2}https://10.40.239.128/blogs/2015/07/cold-or-flu-why-the-difference-matters/COLD or FLU Why the Difference MattersCough, congestion, body aches, fever. These are some of the most common symptoms seen in primary and urgent care offices, especially in the so-called &ldquo;cold and flu season&rdquo; of the winter months. Patients young and old feel miserable, but wonder if they should even make the expensive, time consuming and often less than productive visit to the doctor. Here are some key markers to distinguish between a regular cold or the influenza virus, and tips to prepare for the season ahead.&nbsp;
<p><strong>The Common Cold</strong>&nbsp;</p>
<p>Viruses are microscopic infectious organisms that are generally very contagious. There isn&rsquo;t just one virus that causes the common cold, but rather an entire group such as rhinovirus, coronavirus, adenovirus, and metapneumovirus. Such viruses are associated with a variety of symptoms like runny nose, congestion, cough, sneezing, fever and body aches. To date, medical science has produced very limited treatment options for colds. Most over-the-counter medications have, at best, modest effects on symptoms. Antibiotics don&rsquo;t treat colds and vaccines to prevent the cold don&rsquo;t exist. Luckily, for us, our immune system is our greatest defense against the common cold.&nbsp;
</p>
<p>A typical cold will last on average three to 10 days. The majority of the symptoms are actually not caused by the infection itself, but rather our body&rsquo;s immune system trying get rid of it. Most cold viruses will go away if we are patient and give our bodies time to fight them. Secondary bacterial infections are possible, such as ear infections, sinus infections and pneumonia. These are usually the culprits when someone with a cold abruptly gets worse or remains sick beyond the typical 10 days of a regular cold. At this point, an antibiotic can be helpful and it may be time to see your physician.&nbsp;
</p>
<p><strong>Influenza</strong>&nbsp;</p>
<p>In contrast, there are some viruses like influenza that are much more aggressive and even fatal. Influenza, or flu, is generally characterized by a sudden onset of high fever (102 to 103 F), body aches and cough. Flu can cause all of the same symptoms as cold viruses, but typically to a much greater degree. Flu is a truly miserable experience for anyone who contracts this illness. Similar to cold viruses, there isn&rsquo;t a cure. Different from cold viruses, there are options for treatment and prevention. Flu is an often misunderstood illness. Here are five ways to understand the flu a little better.&nbsp;
</p>
<p><strong>1. FLU DOES NOT CAUSE VOMITING &amp; DIARRHEA</strong>&nbsp;</p>
<p>Influenza is a respiratory illness. Although people can have vomiting and diarrhea, this is neither typical nor common. This common misconception can lead people to misunderstand what flu is really like, when to seek care, and what flu vaccination prevents. Acute vomiting and diarrhea is frequently caused by a virus, but it&rsquo;s not the flu virus.&nbsp;</p>
<p><strong>2. FLU CAN BE FATAL</strong>&nbsp;
</p>
<p>Estimates of annual flu-associated deaths in the United States since 1976 range from a low of about 3,000 people in 1986-87 to a high of about 49,000 people in 2003-04, according to the Centers for Disease Control and Prevention (CDC). Certain people are at higher risk for complications from flu including older people, infants, children, pregnant women and people with chronic medical problems (heart disease, asthma, diabetes, etc.). However, it is possible for people in great health to get flu and end up very sick, hospitalized, and possibly pass away within a matter of days. This is tragic. Flu is a serious illness that deserves the attention we give it each year.&nbsp;
</p>
<p><strong>3. Flu Is Preventable</strong>&nbsp;</p>
<p>Vaccination is the best way to way to prevent flu. Each year, vaccines are produced to protect against three to four flu virus strains, based on previous years, previous epidemics and what the CDC predicts will be active. Annual vaccination is necessary because flu virus is remarkable for its high rates of mutation, making it difficult for our immune systems to protect against new variants.&nbsp;</p>
<p>Vaccines are available in different forms, including shots and nasal sprays. Selecting the vaccine that is best for you is something to discuss with your physician. Vaccination is recommended for anyone age 6 months and older. Vaccines typically become available in October, and early vaccination is recommended to allow your body time to produce immunity prior to flu outbreaks. Vaccination is effective. It is estimated to reduce mortality by 41 percent (as high as 75 percent reduction for those previously vaccinated, but as low as 9 percent for those being vaccinated for the first time).&nbsp;
</p>
<p>The most common reasons patients decline to be vaccinated are 1) &ldquo;I never get the flu,&rdquo; and 2) &ldquo;The flu vaccine makes me sick.&rdquo; To the first point, flu can affect anyone, even if a patient has been lucky so far. To the second, post-vaccine symptoms are actually an immune response, showing that they are producing immunity to the virus, and thus will be protected. This response is generally much less than they would experience if they actually got sick.&nbsp;
</p>
<p><strong>4. TREATMENT IS AVAILABLE</strong>&nbsp;</p>
<p>As mentioned above, doctors don&rsquo;t have any good treatments for cold viruses. We do, however, have a few anti-virals that are useful for influenza. Tamiflu (oseltamivir) and Relenza (zanamivir) are recommended for severe infections (hospitalization, pneumonia), individuals at high-risk of complications, and others deemed appropriate by physicians. Treatment must be initiated within 48 hours of symptom onset to be effective. Although these are not curative drugs, their use has been shown to reduce duration, severity and complications of influenza. If you think you have the flu, seek care early.&nbsp;
</p>
<p><strong>5. FLU IS HIGHLY CONTAGIOUS</strong>&nbsp;</p>
<p>We don&rsquo;t really know why flu comes back each winter, year after year. It typically starts abruptly, peaking within 2-3 weeks, but then lingers for a few months. We do know that the virus is carried in respiratory secretions, and spread by things like coughing and sneezing. Close contact, less than 6 feet, is usually required, but viruses can live on skin and other surfaces and spread through contact with these. People are thought to be contagious one day before and up to five days after symptoms start. Flu is very contagious. If you get sick, seek care, but otherwise, stay home. Frequent hand washing and covering your mouth while coughing or sneezing is necessary to reduce spread of this pesky virus.&nbsp;
</p>
<p>Please remember, cold and flu season is coming. The time to get ready is now. Colds are generally mild, require little to no treatment, and go away with the help of our miraculous immune system. Flu is a more serious respiratory viral infection for which there are preventative and treatment options available. Get vaccinated, but if you get the flu, see your doctor to discuss testing and treatment.
</p>Tue, 14 Jul 2015 00:00:00 -0600{AD797964-FE91-4E3C-97AD-656267FD1885}https://10.40.239.128/blogs/2015/07/keeping-pace/Keeping Pace - An Introduction to Abnormal Heart RhythmsThe heart has a built-in electrical system, which consists of a pacemaker and a set of specialized structures that distribute the electrical signal to the heart muscle. Each time the pacemaker fires, the electrical signal is sent to every cell in the heart and tells them to beat in a precise sequence. The heart&rsquo;s pacemaker continuously monitors the body&rsquo;s activity level, and adjusts the heart rate according to the body&rsquo;s needs. While we are sleeping, the heart rate can slow to as slow as 40-50 beats a minute, and with exercise, can go as fast 180 to 200 beats a minute. Most of the time, we are hardly aware of this amazing organ pumping away in our chests, keeping us alive and monitoring us continuously. However, in some cases, the electrical system in the heart can act up. Instead of our usual, regular heartbeat, the heart can beat too slowly, too quickly or in a different sequence than usual. This is what cardiologists refer to as an arrhythmia. Fortunately, most arrhythmias are not dangerous; some, however may be dangerous or even life threatening. Electrophysiologists are cardiology specialists who deal with heart rhythm disorders. If you are diagnosed with an arrhythmia or experience palpitations, you may be referred to an electrophysiologist for evaluation and treatment.&nbsp;
<p>There are many different types of arrhythmias. Some may be completely asymptomatic, whereas others can manifest with palpitations, lightheadedness, shortness of breath, and rarely, loss of consciousness or even sudden death.
SVT: Supraventricular Tachycardia&nbsp;</p>
<p><strong>SVT:</strong> or supraventricular tachycardia, is a medical term for a fast heart rhythm that originates in the heart&rsquo;s upper chambers, or atria (hence supraventricular because the arrhythmia comes from above the ventricles). No one knows exactly why some people get SVT and others do not, but we know that there are a few types of SVT.&nbsp;
</p>
<p><strong>AVNRT and AVRT:</strong> extra loops of electrical circuitry in the heart AVNRT, or A-V Node Reentrant Tachycardia, and AVRT, or atrioventricular reciprocating tachycardia, are two common types of SVT. Both are caused by an electrical &ldquo;short circuit&rdquo; when the electrical signal starts spreading to the heart, but then ends up going around and around in a loop, making the heart beat quickly. People often experience palpitations because of the rapid heart rate and the irregular sequence of contraction of the atria and ventricles. The episodes usually last from one to several minutes. The episodes can come on at any time, and patients often find that they can break the episodes on their own by holding their breath or bearing down. AVNRT and AVRT are not dangerous rhythms, but can cause very bothersome symptoms such as palpitations, lightheadedness and weakness. Fortunately, this rhythm can be easily treated with either medications or using a catheter-based procedure that is extremely effective in eliminating this rhythm.&nbsp;
</p>
<p><strong>AT:</strong> An alternate pacemaker takes over AT, or atrial tachycardia, is caused by a different area of the atria taking over the hearts pacemaker function and beating very quickly. There is no loop of electrical activity, but a different focus in the heart starts acting up. The symptoms can be very similar to AVNRT or AVRT, and again, either medication or catheter ablation can be very effective.&nbsp;
</p>
<p><strong>Atrial Fibrillation: A growing epidemic</strong>&nbsp;</p>
<p>Atrial fibrillation is one of the most common arrhythmias that cardiologists treat. There are more than two million people in the United States with this condition, and that number is expected to double over the coming decades as the population ages. In atrial fibrillation, the atria have no single pacemaker. Their electrical activity is completely chaotic, beating almost 600 times a minute. As a result, the rate of the ventricles can be very rapid. People with atrial fibrillation may be symptomatic, but many people experience palpitations from the rapid rate, or shortness of breath, fatigue, or passing out. Some people experience short bursts of fibrillation (called paroxysmal atrial fibrillation), and others have it for longer periods of time (called persistent or permanent atrial fibrillation). The longer your atrial fibrillation is untreated, the greater the odds that your fibrillation will become persistent or permanent.&nbsp;
</p>
<p>Atrial fibrillation is important not only because of the symptoms it causes, but also because when the atria are fibrillating, blood flow through them can be sluggish and non-uniform. This is a risk factor for forming clots in the atrium, which can dislodge and cause a stroke. Your physician can determine how high that risk is, and whether you should go on a blood thinner. In addition, you may need to take a medication to control your heart rate, or an antiarrhytmic medication to prevent the atrial fibrillation. If you cannot take an antiarrhythmic, or the atrial fibrillation is very bothersome to you, your electrophysiologist can do a procedure called a pulmonary vein isolation (PVI) to control your atrial fibrillation. At McKay-Dee, cardiologists use both traditional catheter ablation to perform this procedure, as well as a novel technique called cryoballoon isolation, a proven technique that makes the procedure shorter.&nbsp;
</p>
<p>The more we learn about atrial fibrillation, the more we learn that it is related to other medical conditions. Diabetes, high blood pressure, thyroid problems, obesity and sleep apnea are all associated with an increased incidence of atrial fibrillation. Your cardiologist or electrophysiologist will discuss managing these important medical conditions with you.&nbsp;
</p>
<p><strong>Ventricular Rhythms</strong>&nbsp;</p>
<p>Unlike SVT, which originates in the upper chambers of the heart, there are abnormal rhythms that originate in the lower chambers, the ventricles. Most common are PVCs, or premature ventricular contractions. These are extra heart beats that come from the lower chambers. They are commonly felt as &ldquo;skipped beats&rdquo; or &ldquo;extra heart beats.&rdquo; PVCs for the most part are not dangerous, however, too many PVCs can actually weaken the heart. If you have very bothersome PVCs, or if you have a lot of them, you may need to be evaluated more thoroughly. As with other arrhythmias, you can be managed with either a catheter-based procedure or with medications.&nbsp;
</p>
<p>Ventricular tachycardia is a continuous series of ventricular beats. This rhythm can be dangerous, since in some patients the heart does not pump blood to the brain and other organs; in this case the patient will lose consciousness, or can even die. Fortunately, ventricular tachycardia is not a common arrhythmia. It occurs most often in patients with preexisting heart disease. If you have had ventricular tachycardia, or if you have a history of heart disease, you may be referred to an electrophysiologist. Ventricular tachycardia can be treated using catheter ablation. In some cases where the risk of recurrent ventricular tachycardia is high, your electrophysiologist may discuss implanting an Implantable Cardiac Defibrillator (ICD) device. This device is implanted under the skin near your shoulder, and it monitors your hearts rhythm. If it detects a dangerous rhythm like ventricular tachycardia, it can shock your heart into normal rhythm.&nbsp;
</p>
<p>Ventricular fibrillation is a completely chaotic rhythm with no organized electrical activity or organized contraction of the heart. Because the ventricles are the main pumping chambers of the heart, ventricular fibrillation results in immediate loss of blood flow. Patients with ventricular fibrillation will suddenly lose consciousness and require immediate CPR and an electric shock delivered through a defibrillator to survive. Ventricular fibrillation can be caused by heart attack, among other causes. When someone &ldquo;drops dead&rdquo; of a heart attack, it&rsquo;s often because of ventricular fibrillation. This is why when you see someone collapse suddenly, it&rsquo;s so important to start CPR right away and get an external defibrillator, since the only way to treat ventricular fibrillation is using an electric shock, or cardioversion, to convert the heart to a normal rhythm.&nbsp;
</p>
<p>The vast majority of all heart arrhythmias can be easily and effectively treated. With new advances and technology in the field of electrophysiology, you can now start with medications or opt for a catheter-based procedure to treat your arrhythmia in most cases.&nbsp;
</p>
<p>Hopefully, you never have a heart rhythm problem, but if you do, you can rest assured that the providers at McKay-Dee Heart Rhythm Specialists are trained in the latest techniques, technologies and procedures in electrophysiology, and we are always willing and able to help you.
</p>Tue, 14 Jul 2015 00:00:00 -0600{8217EA8C-18B6-4975-92F4-1D1986F7D7CF}https://10.40.239.128/blogs/2015/07/from-diagnosed-to-doctor/From Diagnosed to Doctor - A Physician with personal experience<em>Every physician gathers experience and knowledge in their field, but few receive personal experience in their specialty.
I&rsquo;ve been on both sides of the endoscopy table. My story includes sacrifice, empathy, positivity and family; but above all, it&rsquo;s a story of brotherly love.</em>&nbsp;
<p>In a way, I began my gastroenterology career many years before med school. I was in Frankfurt, Germany, serving a mission for The Church of Jesus Christ of Latter-day Saints, when I first experienced several symptoms that I now provide medical care for: I felt extremely fatigued, suffered abdominal pain in the upper right quadrant, had bright orange urine and jaundiced skin. Something was clearly abnormal. After a week in a Frankfurt hospital, physicians ruled out viral hepatitis and began suspecting Primary Sclerosing Cholangitis (PSC), a longterm, chronic disease that attacks bile ducts and can eventually deplete liver function. Thankfully, the disease progresses slowly, so I completed my mission with only a few bouts of nausea, abdominal pain and jaundice.&nbsp;
</p>
<p>Once physicians in the United States confirmed the PCS diagnosis post-mission, I more fully comprehended the meaning of the acronym. I learned that the disease affects men more than women; and that only six out of every 100,000 people have it. For any football fans, I found out that PSC is the same autoimmune disease that Chicago Bears football great Gary Payton died from. Plus, I began to seriously consider the complications and consequences associated with the disease, like infections, liver failure, and bile duct and colon cancer. Most dramatically, I realized that a new liver was the only sure way to beat the disease &hellip; But I wasn&rsquo;t ready for a liver transplant &hellip; yet.&nbsp;
</p>
<p>After a few more years, I completed my bachelor&rsquo;s degree, married my sweetheart and moved to Phoenix, Ariz. to attend medical school. I instinctively felt compelled to study the same anatomy being annihilated in my own body &ndash; knowing that my personal experience would someday instill a tremendous amount of empathy for future patients. By the time I reached my second year in med school, my trusted physician explained that the PSC had progressed significantly. With scarred bile ducts and an impeded liver, I wasn&rsquo;t considered sick enough to qualify for a liver transplant from a deceased donor, but I was at an ideal stage for a living donor transplant. That&rsquo;s when an immeasurable amount of love poured in.&nbsp;
</p>
<p>To offer someone else a vital organ is an awe-inspiring gift. Several friends and family members volunteered their livers in my behalf. It turned out that both my younger sister and brother matched my blood type; and since my brother&rsquo;s body size complements mine, the physicians deemed him as the best donor match.&nbsp;
</p>
<p>My brother Kyle is five years younger than me, and growing up as the only boys in our family, we&rsquo;ve always been best friends. By providing me with a little more than half of his liver, he became more than my best friend &ndash; he became a type of personal savior. A savior is described as an individual who does something for a person that the person can&rsquo;t do for themselves. I couldn&rsquo;t grow or provide myself with a new liver, and would have died without my brother&rsquo;s intervening gift. Every day, I feel an overwhelming sense of gratitude for his sacrifice and brotherly love.&nbsp;
</p>
<p>Approaching the transplant, I felt deep concern about my brother&rsquo;s health. Removing the liver comes with great risks, and sadly, there have been similar cases when the healthy donor died and the recipient lived. That became my darkest nightmare. On the other hand, my brother&rsquo;s main concern focused on me and my health; as he knew that transplanting the liver is one of the biggest and most involved abdominal surgeries in existence.&nbsp;
</p>
<p>Nevertheless, our faith overcame our fear. The transplant took place at the Good Samaritan Hospital in Phoenix, Ariz. by a fabulous team of physicians and medical staff. With their medical expertise, and with much prayer, fasting, and support from family and friends, the transplant proved successful. It took my brother about three months to fully recuperate his energy, and about that same amount of time for his liver to regenerate to normal size. Amazingly, I missed more than a month of med school and still walked with my class at graduation.&nbsp;
</p>
<p>On Dec. 1, 2014, we celebrated the ten year anniversary of our transplant. Looking back, it&rsquo;s obvious that the event stands as a pivotal and defining moment in my life, as well as my brother&rsquo;s. I believe we are stronger brothers, friends and physicians because of this trial.&nbsp;
</p>
<p>After the transplant, both my brother and I became gastroenterologists; as it seemed natural and necessary to share our knowledge and experience with others in similar circumstances. Today, we feel blessed to serve patients who we relate to on a variety of levels &ndash; emotional, mental and physical. We relate to the worrisome thoughts that come at night, we understand the family conversations that focus on health, and we foresee many questions patients ponder. We&rsquo;ve felt similar fears, and also similar joys that come with medical care. I know that this empathy makes us better physicians, and I marvel at the many times our experiences provide benefit for others.&nbsp;</p>
<p>For example, I recently cared for a single young woman, less than 30 years old, who was at risk for colon cancer. Best practice protocols recommend removal of the colon in high risk situations; and if it&rsquo;s low risk, patients have the choice to either remove the colon or continue with a vast number of random biopsies in six months. The thought of having her colon extracted, and therefore being permanently attached to a bag in order to remove bodily waste, left my patient sobbing tears of despair. And, oh, how I could relate to her initial shock and worries.&nbsp;
</p>
<p>A few years after my transplant, I too needed a colectomy (due to ulcerative colitis, a common consequence of PSC). I empathized with this young woman&rsquo;s fears, and pacified some of them. In sharing my story with her, I assured her that an active lifestyle can continue even when a person is required to wear a bag of bodily waste near the front of the abdomen. As the conversation progressed, the young woman&rsquo;s tears dried, she began to breathe more deeply and her head wrapped around the concept. She realized she could still experience a relatively normal, high quality life; and she walked away from the appointment with hope.&nbsp;
</p>
<p>My wise brother notes that some people receive trials in life, while other people choose them &ndash; but either way, we all face difficulties. He&rsquo;s spot on. In our circumstance, he chose to become a living liver donor, while I received the lot of recipient &ndash; either way, we both faced something difficult. I&rsquo;ve found the most rewarding results come by transforming trials into beneficial experiences for others. And bottom line, that&rsquo;s why I dedicate my time and talents to metamorphosing the brotherly love given to me into brotherly love and the best quality healthcare for the patients I serve.</p>Tue, 14 Jul 2015 00:00:00 -0600{97BFF2AB-836F-4A50-83BE-B8F6B48F3C91}https://10.40.239.128/blogs/2015/07/four-safety-tips-to-keep-you-safe-in-the-great-outdoors/4 Tips to Keep You Safe in the Great Outdoors<p>Crews from the Intermountain Life Flight air rescue programs are kept busy every summer helping people who&rsquo;ve become stranded on a ledge or are injured from a fall while in the backcountry. </p>
<p>Their advice: &nbsp;Follow the Boy Scout motto of &ldquo;Be Prepared&rsquo; &ndash; it just may save your life. </p>
<p>Here are four safety tips from Life Flight paramedic Cathie Cooper you should consider before heading out into the wilderness and beyond:</p>
<p><strong>1. First and foremost: </strong>Tell someone where you are going and when you will be back so that in the event of injury or illness they know where you are and when to seek help.</p>
<p><strong>2. Make wise decisions before you head out</strong></p>
<p>-Ask yourself: Are you in proper physical condition for the trip?</p>
<p>-Plan to stay hydrated - take water (maybe even a water filter).</p>
<p>-Wear proper clothing and footwear.</p>
<p>-Pack the "<a href="https://en.wikipedia.org/wiki/Ten_Essentials" target="_blank">10 Essentials</a>".</p>
<p>-Know how to find the safest route if you&rsquo;re hiking; avoid hazardous terrain.</p>
<p>-Know the weather forecast for the area.</p>
<p><strong>3. Consider the consequences of the decisions you make while you&rsquo;re in the backcountry</strong></p>
<p>-Always stay with your group &ndash; don&rsquo;t wander off alone</p>
<p>-Be cautious when jumping or running on rough terrain, or when swimming</p>
<p>-Avoid risky situations, like off-trail traveling or scrambling</p>
<p>-Control your ego &ndash; you don&rsquo;t have to prove yourself to anyone by doing something stupid</p>
<p>-Be responsible for yourself, partners and children</p>
<p><strong>4. If you have a problem, remember that a rescue may take a while &ndash; so pack food, water, clothing and other resources you may need. Here&rsquo;s why: </strong></p>
<ol>
<li>It takes time for search and rescue teams to deploy</li>
<li>Other factors that may delay a rescue include weather, terrain, and time of day or night</li>
</ol>
<p>Just like the Boy Scouts, being prepared before entering the backcountry may mean the difference between life and death.</p>Tue, 14 Jul 2015 00:00:00 -0600{B133A34B-DA72-46D4-BBFA-0BD85F16D056}https://10.40.239.128/blogs/2015/07/back-pain-most-will-experience-it-but-what-can-be-done/Most Will Experience Back Pain, but What Can be Done<p>Whether working in the garden or shoveling snow, back pain can happen at any time of the year.&nbsp; It is important to know what to do and what to expect.&nbsp; For many people back pain is a constant thing, there is help for those individuals as well.&nbsp; </p>
<p> </p>
<p>Most low back pain is acute, or short term, and lasts a few days to a few weeks. It tends to resolve on its own with self-care and there is no residual loss of function. The majority of acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back (the spine, muscle, intervertebral discs, and nerves) fit together and move.</p>
<p> </p>
<p>A recent poll found 40 percent of Utahns had no idea where to go when their back isn't feeling well, and bed rest is often a bad idea. Doing nothing sometimes does not help, laying in bed is sometimes the worst thing you can do for a back problem.</p>
<p> </p>
<p><strong>What to do when you experience a back injury?</strong></p>
<p>Get in to see your doctor or physical therapist soon after the injury. Treatment started quickly after the injury has a better chance for quicker results. Most of the time bed rest is one of the worst things you can do after a back injury and leads to longer more severe pain.&nbsp; </p>
<p><strong>What causes of back pain?</strong></p>
<p>There are many causes of back injury however it is very common to occur when lifting something with poor body mechanics. There is usually a combination of factors related to flexibility, core strength, and general posture. People who get back pain vary from elite athletes with high demands on their back, to sedentary individuals who lack the strength and posture to properly support their spine.&nbsp; </p>
<p><strong>Do most people need an MRI for their back pain?</strong></p>
<p>Your doctor can determine the need for an MRI however, an MRI is not necessary for the vast majority of people suffering from back pain. Imaging often does not show the cause of back pain and treatment is typically best determined by a physical exam.&nbsp; &nbsp;</p>
<p><strong>What can be expected when someone is treated for back pain?</strong></p>
<p>Therapists will identify motion restrictions as well as areas of weakness in supporting muscles. Treatment often consists of the therapists proving techniques to restore joint mobility as well as specific exercises targeted at the core muscles.&nbsp; Early restoration of joint mobility has been shown to yield very positive improvements. Posture and proper instruction in lifting mechanics is very important as well.&nbsp; For a sudden bout of low back pain resolution can often be expected between 4-6 weeks</p>
<p><strong>What can People do to prevent back pain?</strong></p>
<p>Weight management and keeping a good fitness level is important. Maintaining proper lifting techniques and avoiding repetitive bending and lifting through the back is also important.&nbsp; Back braces should never be worn long term as they create dependency and weaken the muscles making it more likely to have a more serious injury.&nbsp;&nbsp; </p>
<p><a href="http://intermountainhealthcare.org/hospitals/tosh/Pages/home.aspx" target="_blank">TOSH Back and Neck Center</a> in Murray can help. It's kind of an InstaCare for back and neck pain patient. The center tries to see most patients within one to two days. The idea is to get people in immediately, diagnose their pain and get them the help they need in less time.</p>
<p> </p>
<p>Staffed by a nurse practitioner, a physical therapist and an educational psychologist, the TOSH Back &amp; Neck Center uses a multi-faceted approach to evaluate and treat patients. Rapid, triage-style assessments help determine the source of pain, and patients can then immediately transition to the appropriate spine care specialist who establishes a plan for pain management through medication, physical therapy and education. Because the center is located within TOSH, patients are able to obtain same-day or next-day access to the facility's state-of-the-art diagnostic services, including X-ray, MRI and CT scanners.</p>
<p> </p>
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<p> </p>Mon, 13 Jul 2015 00:00:00 -0600{3C0D92A6-3555-492D-AC6D-C73D89B83B2F}https://10.40.239.128/blogs/2015/07/vote-for-intermountain-healthcare-in-usaid-saving-lives-at-birth-challenge/Vote for Intermountain Healthcare in USAID &quot;Saving Lives&quot; at Birth Challenge<p><strong>USAID Saving Lives at Birth Grand Challenge for Development</strong></p>
<p>In February, the&nbsp;USAID <em>Saving Lives at Birth: A Grand Challenge for Development</em>&nbsp;launched their fifth call for groundbreaking, sustainable innovations to save the lives of mothers and newborns in remote parts of the world &ndash; and Intermountain Healthcare responded to the call. The <em>Saving Lives at Birth</em> program, which mobilizes the world&rsquo;s brightest thinkers, is an important part of a global effort to bring an end to the 289,000 maternal deaths, 2.8 million newborn deaths, and 2.6 million stillbirths that occur each year.</p>
<p>The<em> </em>challenge, launched in 2011, is run by a partnership of several organizations, including the U.S. Agency for International Development (USAID), the Government of Norway, the Bill &amp; Melinda Gates Foundation, Grand Challenges Canada (funded by the Government of Canada), and the U.K&rsquo;s Department for International Development (DFID).</p>
<p>The program&nbsp;seeks and rewards groundbreaking prevention and treatment approaches for pregnant women and newborns in poor, hard-to-reach communities.</p>
<p><strong>Every two minutes, a woman dies in childbirth.</strong></p>
<p>In sub-Saharan Africa, women are 136 times more likely to die than in developed countries.&nbsp;We also know that healthy mothers help raise healthy children who get better food and more time in school &ndash; leading to stronger families, communities and nations.</p>
<p>Most of the maternal-fetal deaths that occur between labor onset and 48 hours after birth happen in low- and middle-income countries, especially in sub-Saharan Africa and South Asia, where access to quality care is also the poorest. With limited access to electricity, clean water, adequate transportation, and trained healthcare professionals, women in these parts of the world often go without the life-saving care they need at the time of birth.</p>
<p><strong>The challenge</strong></p>
<p>Innovators from a range of organizations &ndash; including non-profits, faith-based organizations, universities, and private enterprises &ndash; from all over the world &ndash; such as Australia, Kenya, Pakistan, Canada, Nigeria, and the United States &ndash; work in partnerships to foster creative and sustainable solutions that span&nbsp;science and technology, service delivery, and demand creation. Each of the innovations has the potential to dramatically reduce maternal and neonatal deaths at the community level.</p>
<p><strong>Intermountain&rsquo;s entry:</strong></p>
<p>Our very own <a href="http://intermountainhealthcare.org/services/womennewborn/Pages/home.aspx" target="_blank">Women &amp; Newborn</a> experts have made it to the finals in the challenge, advancing past hundreds of other competitors. </p>
<p>This is a summary of the Intermountain entry:</p>
<p style="margin-left: 0.5in;">&ldquo;Babies and mothers die and have long-term health problems from preventable causes, nearly all in low income countries. Despite recent successful interventions in Bangladesh, mortality rates remain high because most births occur at home with unskilled traditional birth attendants (dais). </p>
<p style="margin-left: 0.5in;">Our proposal centers on development of a novel device to help the untrained, illiterate user recognize complications in pregnant mothers (Science &amp; Technology) with dissemination of the device by government health workers to dais in a way that fosters education (Service Delivery). </p>
<p style="margin-left: 0.5in;">Empowerment of dais through technology, education and support will in turn motivate pregnant women to pursue healthy behaviors (Demand Creation). Our objectives are to create a low-cost, handheld, solar-powered, ultrasound and cell technology- based device with embedded automated algorithms for fetal gestational age, growth, presentation and number, as well as placental location; validate the ability of this device to identify pregnant mothers at risk of complications; and test the efficacy of the device in improving care seeking behavior (of both mothers and their dais) and maternal/neonatal outcomes. </p>
<p style="margin-left: 0.5in;">This proposal combines medical, engineering, and public health expertise in a unique global marriage of institutions. Assuming success in these objectives, we will&nbsp;scale up the intervention stepwise throughout Bangladesh and, ultimately, globally.&rdquo;</p>
<p><strong>What can you do?</strong></p>
<p>You can help Intermountain be selected as a &ldquo;People&rsquo;s Choice Award&rdquo; winner of the challenge by voting for our entry. Just go to <a href="https://savinglivesatbirth.net/summaries/2015/414">https://savinglivesatbirth.net/summaries/2015/414</a> and create a login to vote! The challenge organizers have not specified how many finalists will receive funding, so your vote may really help make a difference as we strive to promote the health and wellbeing of mothers and newborns around the world.</p>Mon, 13 Jul 2015 00:00:00 -0600{DF40542A-935E-49B9-AD3A-CA1551799503}https://10.40.239.128/blogs/2015/07/cannot-take-statins-to-lower-your-cholesterol-new-drug-offers-new-hope/Can&#39;t Take Statins to Lower Your Cholesterol? New Class of Drugs Offers New Hope<p class="p1">If approved, the new injectable drugs would be the first in a new class of drugs &mdash; known as PCSK9 inhibitors &mdash; to treat high cholesterol.. The drugs block the PCSK9 protein found in the body, which then allows the liver to remove LDL cholesterol from the blood. Studies show the drugs can drastically reduce bad cholesterol to extremely low levels without producing the side-effects suffered by some people who take statins.</p>
<p class="p2">&ldquo;Blocking the PCSK9 that&rsquo;s naturally produced allows the body&rsquo;s cholesterol to go way down,&rdquo; says Brent Muhlestein, MD, a cardiologist at the Intermountain Medical Center Heart Institute. &ldquo;The LDL cholesterol is then able to drop by 60-70 percent when you take these injections."</p>
<p class="p1">Right now, patients with high cholesterol depend on statins like Lipitor, Mevacor, and Crestor to keep their cholesterol levels low. However, some patients with high cholesterol don&rsquo;t respond well to statins.</p>
<p class="p1">Max Kunzler is one of them.</p>
<p class="p1">Max suffers from hereditary high cholesterol, so eight years ago he started taking statins to bring his LDL cholesterol down. However after experiencing some bad side-effects from the statins, like cramps in his legs that prevented him from walking, he stopped taking them.</p>
<p class="p2">&ldquo;While I haven&rsquo;t been able to take any statin drugs to get my cholesterol down, I&rsquo;ve actually ended up having two heart attacks,&rdquo; says Kunzler.</p>
<p class="p1">People who are intolerant to statins or can&rsquo;t get their cholesterol low enough even with statins would be the biggest benefactors of these new drugs once they&rsquo;re approved.</p>
<p class="p1">&ldquo;If your body produces too much cholesterol you&rsquo;re just stuck at the present time,&rdquo; says Dr. Muhlestein. &ldquo;However cases like Max make me excited about the possibility of having these new injectable drugs. They will really make a difference in the way we treat their cholesterol and allow them to live a better life.&rdquo;</p>
<p class="p1">For more information on these new drugs and to see how they&rsquo;ll benefit people who are intolerant to statins, watch this <a href="http://kutv.com/features/health/check-your-health/check-your-health-new-cholesterol-drugs" target="_blank">Check Your Health KUTV report</a>.</p>Mon, 13 Jul 2015 00:00:00 -0600{408338E9-7BC8-40FA-8B7B-BB128DBB2565}https://10.40.239.128/blogs/2015/07/what-do-dietitians-eat/What do Dietitians Eat?<p>At Intermountain Healthcare, our mission is to help people live the healthiest lives possible. Intermountain employs over 165 dietitians who work every day to share their knowledge of healthy eating with people in our hospitals, clinics, and communities. <a href="http://intermountainhealthcare.org/services/nutrition-services/Pages/home.aspx" target="_blank">Our dietitians</a> are a great example of how healthy eating can still be an enjoyable experience.&nbsp; We asked Intermountain dietitians from all over Utah what their favorite foods were and here are some of our favorite responses:</p>
<p><strong>Greek Yogurt</strong></p>
<p>Light Greek yogurt is a tasty way to boost protein intake, stabilize blood sugar, and help with satiety! &nbsp;You can make ranch dip with it and serve with veggies for a fat-free, high-protein snack.&nbsp; Flavored varieties of Greek yogurt are great with oatmeal in the morning (instead of milk) for a filling breakfast to keep you going until lunchtime. ~<em>Jenessa Henrie, Primary Children&rsquo;s Hospital dietitian</em></p>
<p><strong>Nuts</strong></p>
<p>A handful of raw or dry-roasted nuts!&nbsp; These make a great, easily-portable snack anytime you have the munchies as they are really satisfying and are full of heart-healthy fats, vitamins and minerals.&nbsp; ~ <em>Margaret Braae, Primary Children&rsquo;s Hospital dietitian</em></p>
<p><strong>Black Beans</strong></p>
<p>I love black beans or any beans for that matter.&nbsp; My kids make fun of me because I eat them ALOT!&nbsp; They are tasty, easy to throw together, very satisfying, and a good source of fiber and protein. <em>~Valery Shaw, Riverton Hospital dietitian</em></p>
<p><strong>Sun Dried Tomatoes</strong></p>
<p>Lately, one of my go-to foods has been sundried tomatoes. They work great on paninis, pasta, or pizzas (especially ones cooked on the barbecue grill). By using the dehydrated fruit, you retain the yummy tomato flavor while reducing some of the water content, which can cause sogginess in some recipes. They are a good source of fiber and antioxidants. Some of the ones you buy at the store can be higher in sodium, so make sure to check the label! <em>~Jessie Hatch, McKay-Dee dietitian</em></p>
<p><strong>Berries</strong></p>
<p>My favorite food is berries (strawberries, raspberries, blackberries, blueberries, etc.)&nbsp; Not only are they colorful and delicious, they are also high in antioxidants and polyphenols &ndash; which help fight chronic disease.&nbsp; Have a &frac12; cup for a snack or add to yogurt, a green salad or a smoothie!&nbsp; <em>~Kathryn Kauffman, Dixie Regional Medical Center dietitian</em></p>
<p><strong>Arugula</strong></p>
<p>When I&rsquo;m cooking Italian at home, baby arugula in a salad is one of my favorite ingredients. Its peppery flavor is like nothing else and with a drizzle of balsamic vinegar or lemon juice, some olive oil and some parmesan cheese slivers, it is a wonderful, authentic Italian addition to any meal. <em>~Regan Wilson, Valley View Medical Center dietitian</em></p>
<strong>Chocolate</strong>
<p>I love chocolate &ndash; the darker the better!&nbsp; Not only does a small piece of high-quality dark chocolate go a long way in satisfying my sweet-tooth, but I love that a dessert can give me a boost of healthy antioxidants and flavenoids! <em>~Joy Musselman, McKay-Dee Hospital dietitian</em></p>
<p><strong>Fruit Salad</strong></p>
<p>Fruit salads are the perfect side at family mealtime &ndash; quick, colorful, and delicious!&nbsp; Simply cut 2 to 4 different fresh fruits (about 1 piece of fruit per person) into bite-sized pieces and mix together.&nbsp; Any combination of fruit can work.&nbsp; Some of my favorite combinations are a traditional blend of apple, orange, and banana or try a&nbsp;summer variety of watermelon, cantaloupe, and blueberries or even a tropical mix of mango, kiwi, and pineapple<em>.&nbsp; ~Katie McDonald, Primary Children&rsquo;s Hospital dietitian</em></p>
<p><strong>Cucumbers </strong></p>
<p>One of my favorite foods is garden fresh cucumbers.&nbsp; I can eat them like candy, and they really are a better alternative for the afternoon munchies.&nbsp; They are also great in salads, sandwiches, and wraps.&nbsp; <em>~Mary Brown, Dixie Regional Medical Center dietitian</em> (Editor&rsquo;s note: Mary also shared that doughnut holes are another favorite, &ldquo;I only buy them 2-3 times a year, but I do love them!&rdquo;&nbsp; As dietitians we believe all foods can fit in a healthy diet &ndash; even less nutritious foods when eaten in moderation.)</p>
<p><strong>Apples</strong></p>
<p>Although they may seem cliche as a stereotypical "health food", this fruit is a must-have in my life. There are&nbsp;many varieties of flavors and textures to appeal to individual preferences.&nbsp;Apples&nbsp;hold up especially well as a travel snack or in a packed lunch, so&nbsp;I&nbsp;usually have one close at hand. <em>~Marie Stevens, McKay-Dee Hospital dietitian</em></p>
<p>&nbsp;</p>
<p>&nbsp;</p>Fri, 10 Jul 2015 00:00:00 -0600{8F031740-4876-4354-A4E9-2AB528505FA2}https://10.40.239.128/blogs/2015/07/heart-healthy-recipe-ginger-lime-chicken-skewers/Heart-healthy Recipe: Ginger Lime Chicken Skewers<p>I've shared this recipe with the 15 Utah moms I am working with as part of the Intermountain Medical Center Heart Institute's <a href="http://www.myheartchallenge.org" target="_blank">My Heart Challenge: Moms Edition</a> and invite you to try this recipe as well.&nbsp;</p>
<p><strong>INGREDIENTS</strong></p>
<ul>
<li>2 boneless skinless chicken breasts (cut lengthwise into three strips)</li>
<li>NOTE: You can also use chicken tenders</li>
<li>For the marinade:</li>
<li>1 T canola oil</li>
<li>1/2 t crushed red pepper flakes</li>
<li>2 T soy sauce</li>
<li>1 t fresh ginger (minced)</li>
<li>1 clove garlic (minced)</li>
<li>lime juice (1 lime)</li>
</ul>
<p><strong>DIRECTIONS</strong></p>
<ol>
<li>Place a wooden (or metal) skewer through each chicken strip. Place on a plate or in a plastic container.</li>
<li>Whisk all marinade ingredients together and pour over chicken skewers.</li>
<li>Cover and refrigerate chicken for 1-2 hours.</li>
<li>Preheat oven to 375 degrees.</li>
<li>Roast chicken skewers until cooked through (roughly 15 minutes). Grilling is also a great option.</li>
</ol>Fri, 10 Jul 2015 00:00:00 -0600